This Blog

There are 100 million young people in the Middle East and North Africa. They are a force for change in a region at a crossroads. This blog is focused on ideas for tapping into this immense potential and meeting the aspirations for jobs, justice and dignity.

Health

The poorest country in the Middle East and North Africa even prior to the conflict, Yemen has through violence and subsequent economic freefall landed at the epicenter of a series of interrelated emergencies that the United Nations describes as the “world’s worst humanitarian crisis.” This is the first of a three-part blog series on the Bank’s response in Yemen.

In July of this year, I assumed the role of Country Manager for Yemen. Much has happened in my first 100 days as CM.

As one of the forerunners of the World Bank’s new Human Capital Project, Tunisia was one of the six countries that presented their vision for human capital development at the World Bank Annual Meetings held October 10 – 11 in Bali, Indonesia.

“We had lost hope,” said Muneera’s father. “As her health deteriorated and her body weakened, we worried that she could not last much longer.” Six months short of her fourth birthday, Muneera was suffering the effects of malnutrition, which had put her life in danger. Though she lived near Yemen’s capital, Sana’a, Muneera’s family did not have the resources to take her for medical care. Like thousands of other children in Yemen, the deteriorating conditions due to ongoing instability had led to malnutrition.

About a decade ago, we started a project to improve solid waste management for waste pickers like Ibrahim and the 840,000 people in the southern West Bank governorates of Bethlehem and Hebron. One of the project components included the closure of the Yatta dumpsite, where illegally dumped and burned household waste was reaching a very unsanitary and hazardous level.

But here came the challenge.

While the closure of the dumpsite would mean putting an end to a serious environmental and public health problem, it was terrible news for the waste pickers and their families. It meant that the livelihoods of those families would come to an end.

Even before the protractive conflict, implementing development projects in some of the most remote and disadvantaged districts in a number of Yemeni governorates faced significant challenges. To address these challenges, and overcome some of the problems related to access to these remote areas, Yemen’s Social Fund for Development (SFD) devised a program in 2004 to attract youth interested in volunteering to promote development. In its first phase, this program — known as “Rural Advocates Working for Development (RAWFD)” — targeted a number of male and female students from these remote areas and provided them with a development-related program while they are attending universities in major cities. After graduation, these young graduates made a big difference in facilitating SFD operations and activities of other national and international organizations in their home areas.

Everyone agrees that conflicts impose huge costs on economies, including massive destruction of infrastructure and housing, disruption of trade, transport and production, not to mention the loss of lives and widespread human suffering. Yet quantitative estimates of these costs are hard to come by.

Yemen is facing an unprecedented political, humanitarian, and development crisis. Long the poorest country in the Arab region, over half its population was living below the poverty line before the current conflict worsened. That number has risen steeply, with over 21.5 million people needing humanitarian assistance now—close to 80% of the country’s 28 million people.

In February of this year the Syrian Center for Policy Research issued a report stating that 470,000 Syrians had been killed in the war and 1.9 million wounded. That was 10 months ago and with the intensification of the siege and bombardment of Aleppo and ongoing fighting elsewhere in the country, one can only guess at the current toll. What is clear is that each day of fighting adds to the burden that Syria will have to carry for generations to come, not only in terms of the ever mounting physical destruction but also in caring for the growing daily toll of the physically or mentally disabled that the war produces. All this at a time when half the population--nearly 5 million refugees and 6.6 million Internally Displaced Person (IDPs)--have been torn from their homes; and the country’s medical system is in tatters.

After the Arab Spring, Egypt’s health sector went through a shaky transition as seven consecutive Egyptian Ministers of Health struggled to make the sector live up to the revolution’s ideal of a health sector that would serve to uphold human dignity and social justice. Pre-revolution reforms to the sector had focused on expanding access to essential services in family health and to health insurance coverage. The political environment and the sector’s limited capacity had not, however, made it possible for these pilot schemes to be scaled up properly, with a pro-poor focus.